Meniere's disease affects the organs of hearing and balance positioned in the labyrinth of the inner ear. The symptoms are periodic attacks of severe vertigo and balance disorders, tinnitus, a saturated or pressurized sensation of the ear, intolerance versus noice and diplacusis, and also severe perspiration, headache and nausea, the latter symptoms reminding one of side effects when overdosing .beta.-receptor blocking agents. In almost every case, the disease results in permanent hearing loss.
The etiology of the disease is unknown. A theory is that it is associated with a disorder of the osmotic pressure gradient at the blood endolymph barrier. Finally, endolymphatic pressure or chemical imbalance causes permanent hairy-cell damage and deafness. Another theory is that labyrinth cracking alleviates or provokes the vertigo attacks mixing the perilymph and endolymph. During the attack free periods, the patients do not show any disorders accept for the hearing loss. The cause of the hearing loss is believed to be due to an increased pressure in the endolymph and this explains the latin name of the disease, hydrops labyrinthi. As the endolymph volume increases the labyrinth swells resulting in hearing loss and vertigo.
There exists no conventional cure for Meniere's disease. However, patients having a milder form of the disease receive tranquilizers against vertigo provoked anxiety reactions. Further, antihistamines, diuretics and vascular dilatating drugs are administered which do not, per se, affect the inner ear but improve the patient's well-being. In more severe cases, the only solution hitherto has been surgery to destroy the diseased labyrinth in a one time operation or removing endolymph in repeated operations. When performing this destructive surgery, it is necessary that the other labyrinth be healthy to avoid patient deafness. Also, surgical procedures are known not affecting the hearing but these are not always successful. In the case of bilateral Meniere's disease both the vestibular labyrinths can be destroyed by parenteral administration of streptomycin requiring hospitalization of the patient during one or more weeks. Without surgery or other treatment, the labyrinth is destroyed with increasing age.
.beta.-receptor blocking agents have hitherto not been given to patients with audiologic diseases, such as Meniere's disease. In fact, they have never even been considered as a possible cure for Meniere's disease. As an example of this, we refer to "Otolaryngol Head and Neck Surgery", Vol 96, 1987, pages 239-249, in which .beta.-receptor blocking agents are suggested for prophylactic treatment of migraine but, in the case with patients having Meniere-like symptoms, only after the diagnosis of Meniere's disease has been ruled out by audiography.
The most common indications for .beta.-receptor blocking agents today are: cardio-vascular diseases, e.g. hypertension and angina pectoris neurological diseases, e.g. migraine and tremor.